Welcome

Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and
others concerned about HIV/AIDS. Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the
conversation yourself by registering on the left side of this page.

Privacy Warning: Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive
and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a
username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own
physician.

All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators
of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please
provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are
true and correct to their knowledge.

Author
Topic: Doctor's Visit Today (Read 6864 times)

So today I had my first visit with the Doctor since basically I was put onto Atripla and it was pretty ordinary.

However he seems to think that what I was thinking may be Folliculitis or Sebbhoric Dermatitis may in fact be the Atripla Rash that just has never resolved. He gave me a 2 week round of Tetracycline to rule out this being caused by bacteria (I think) and I'll be returning to see him in 3 weeks to get the results of the blood work drawn today. I'm really hoping not to have to change my regimen, but if it clears me up I suppose I'd be all for it. Would swapping the Kaletra for the Sustiva fix me and is Kaletra twice daily? Fingers crossed for good numbers.

Also I kept hinting at him that I would like to have my testosterone checked, but he was either playing obtuse or really didn't get the hint. When I change doctors (and at some point I definitely will be changing doctors) I'm going to ask very directly. I also asked for the list of mutations although I haven't researched them yet here's what they are. Any commentary would be appreciated.

NRTI:118i365i399WT/D

NNRTI:399WT

PI:10WT/i15WT/i63P93L

I have no idea how to make heads or tails of all that except I know WT means Wild Type.

Hey Trey:I started Atripla on 12/4 -- and have noticed that the bottoms of my feet are extremely dry --- is this the type of condition you are having? I didn't get any type of rash in the first few weeks and haven't had really any side effects except the morning grogginess and a few vivid dreams. I will have to check some of my first lab work and see if I have mutations..... I remember seeing a whole lot of alphabet/numeric types of numbers like you listed but really didn't know anything about them. I know that in the area where they listed all of the various HIV drugs it showed no resistance to any of them. When does testosterone usually get affected and how would I know? (Also, just an aside, had to smile when you brought up getting the testosterone checked, after seeing the lady ga-ga may be a man comment in the other post )

The "rash" I'm talking about appeared almost immediately after starting atripla and has slowly over time reduced in severity. I figured initially that my immune system was so beat up that as it started picking back up it was just reacting to every little thing on my skin (I'm no doctor I just rationalized this to myself) because it wasn't a rash per se. It's hard to describe exactly. It occured in very specific areas...Face, behind my ears, upper chest, upper back, and upper arms. Moffie thought it might be folliculitis, Philicia thought it might be Sebbhoric Dermatitis, but after reviewing an exhaustive amount of photos of both afflictions, it just doesn't look like either. The timing is right for it to be the atripla rash, but I just figured I would wait and ask my doctor. He didn't immediately recognize it as anything so beats the hell out of me.

Low testosterone is apparently fairly common in anyone (man or woman I think?) who is HIV positive, the longer you've been infected the worse it can presumably be. If my gallbladder being removed was due to HIV infection then I've been infected for at least 5 years, although my guess is probably closer to 10 since that's when I was pulling extremely stupid sexual stunts. So I'm fairly curious to at least see the number. It's generally associated with a lack of energy, motivation, sex drive and erections.

oh okay -- thanks for the infoI was getting tested about every three to six months prior to being diagnosed -- so I was probably infected about 7/08 -- diagnosed 9/08. I have to check w/ my doctor and see about this dry feet thing --- when I go on 3/1 it will be second visit since starting on Atripla - so i'm hoping vl will b down to "0".

Well I had the same experience as you -- little response about the testosterone question. The thing to do in these situations is press on until you get an answer that you are satisfied. My ID is that busy star type who seems to not want to waste a moment of time. I guess its a matter of trust in someone's expertise. My generalist was perplexed by the testosterone question. And my shrink ignorant but referred me to an neurologist and also spoke about the dynamics of SSRIs. When I had sustiva issues I made them all talk to each other and that got resolved. Otherwise I think one can have too many cooks with egos and specialities and finally they all walk away from the pot and nobody actually seasons the broth.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

If the skin issue continues you might want to ask for a referral to a dermatologist. When I first went on HAART my skin was covered with bumps too. My GP thought it was folliculitis and prescribed an antibiotic (making my ID doc incredibly nervous) but in the end he sent me to a dermatologist.

The dermatologist took about 30 seconds. He said he hadn't seen any since the 90's, but that it was molluscum contagiosum.

Is it worth looking at? I have very high standards. Plus I'm on my second Yuengling Lager so I'm getting horny. I can't decide if I want to watch the Haitian machofucker video or Tim Kruger in the last scene of Reckless.

Well, failing the first two, we resort to charm and size.Seriously though, I hope you get the testosterone answer you need. I'll be making the rounds on that issue again next week and will report in to this thread. Miss P must be right in a nutshell I'm sure there are downsides to T supplementation and you only get it if you really need it.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

I'm not sure about your particular list of mutations but if you have "wild type" that means it's sensitive to most or all of the drugs. Didn't you also get the results of the test where they list each drug and it will say "sensitive" or "resistant" for each one?

There's a Stanford database website where you can put the mutations in and it spits out the info.

If it did get to a point where you wanted to switch, why would you want to switch to Kaletra? Assuming you don't have mutations rendering you resistant, there are many other better choices than Kaletra.

Miss P must be right in a nutshell I'm sure there are downsides to T supplementation and you only get it if you really need it.

It's more like long-term use is largely an unknown, and as I've previously stated over and over the reason I took the chance is for weight gain -- if you drop 35 lbs suddenly like I did you'll do whatever it takes. But if you just have a low number on a lab report and that's it then why take it? Yeah, everyone complains of fatigue but frankly most people with HIV have that even with normalized testosterone numbers. I guess it depends on the severity, but then most fatigue is amplified by depression, and while low t numbers contribute to depression like Dr. Gallant stated and Inchling linked to elsewhere just going on Androgel isn't going to magically reverse one's depression issues.

I think testosterone therapy is valuable in some circumstances, but I think it's wildly over-prescribed now and many HIV specialists I'm sure would agree with my assessment. I also always find it amusing that everyone complains about pill load and seeks the holy grail of once-daily dosing, but when it comes to slapping on the testosterone they sign up in a heartbeat. It's a candified word for gay men.

And on that note I will clearly state that I totally enjoyed being so horny when I had the injections (frankly Androgel didn't increase libido) that not only did I require daily raunchy sex with an actual person, but then later I'd have to watch porn and ride a dildo... and I don't mean a small one either. In the end though that constant need made me more tired, not less, and more stressed out and less focused at work. Oh, and if you think I'm a nasty c*nt now you should have seen me in a roid rage. I was a dildo riding hell-on-wheels high maintenance super-dramafied C*ntessa.

As far as the Testosterone, my doctor ran the test because I hadn't had sex in 2 years, and wasnt really interested in having any, had slight fatigue, erections not as hard as they could be....all the usual suspects.

I tested extremely low (30-40ish, I forget). and yes, it has helped immensely in all the areas above. But I think it's overrated. I thought it would be like cocaine and I would be superman, but eh, its ok. It's become more of a pain in the ass because my insurance no longer covers the gel so i have to use the hideous flesh colored patches.

even though Im not taking injections I do have mini "roid rages" as P calls it, but nothing even CLOSE to what he describes. I also have the headaches. Doc said the only thing she needs to watch while im on therapy is my prostrate size (which is fine with me, I tend to enjoy the exam). Just kidding/ or am I.

Anyways, my point is that your young and unless you are experiencing the Usual symptoms of Low T I wouldn't really worry too much about it.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

As far as the Testosterone, my doctor ran the test because I hadn't had sex in 2 years, and wasnt really interested in having any, had slight fatigue, erections not as hard as they could be....all the usual suspects.

Even when my t numbers were out of range before going on injections I was still as sexually functioning as I'd always been -- never had erection issues, could always manage an orgasm (or two) daily, etc.

If people aren't having sex they need to state if they mean with other people or not even able to masturbate -- and is it a motivation based issue or purely a physical inability. Depression can cause a drop in sexual desire, but if you force the motivation, throw on some German porn, etc. and can still squirt out some jism then the issue is mental or at least partially.

Even when I have depression issues I still force myself to have one daily masturbation session. And not a five minute one either.

Even when my t numbers were out of range before going on injections I was still as sexually functioning as I'd always been -- never had erection issues, could always manage an orgasm (or two) daily, etc.

If people aren't having sex they need to state if they mean with other people or not even able to masturbate -- and is it a motivation based issue or purely a physical inability. Depression can cause a drop in sexual desire, but if you force the motivation, throw on some German porn, etc. and can still squirt out some jism then the issue is mental or at least partially.

Even when I have depression issues I still force myself to have one daily masturbation session. And not a five minute one either.

Good point. Mine was Libido related. We touched on the depression issue and she said Low T can cause Depression.

I was just talking to my partner how many of us don't tell our docs what we want/need. We pay them good money--they work for us. We would not act this way with the plumber or contractor. Society makes docs into gods. Some are god-like, but most are not. I have the same problem that I won't speak up and speak my mind.

I was just talking to my partner how many of us don't tell our docs what we want/need. We pay them good money--they work for us. We would not act this way with the plumber or contractor. Society makes docs into gods. Some are god-like, but most are not. I have the same problem that I won't speak up and speak my mind.

...And on that note I will clearly state that I totally enjoyed being so horny when I had the injections (frankly Androgel didn't increase libido) that not only did I require daily raunchy sex with an actual person, but then later I'd have to watch porn and ride a dildo... and I don't mean a small one either. In the end though that constant need made me more tired, not less, and more stressed out and less focused at work. Oh, and if you think I'm a nasty c*nt now you should have seen me in a roid rage. I was a dildo riding hell-on-wheels high maintenance super-dramafied C*ntessa.

Oh my stars!

I think America's demonization of steroids has made some docs very leery of anything that hints of them.

Just had a visit with my doc too, Hellraiser. I've been on Atripla for 2 1/2 years now and have had no bad side effects to speak of. My CD4s have been holding steady and my VL has been undetectable for almost 2 years now. At first it was off the chart and I started with a lonely little CD4 count of 53. That scared the crap out of me to know that it had gotten so low. Good luck with the therapy. I hope you get your skin issues resolved.

These are improvements in both. My Viral Load had a blip 2 tests in a row to around the 80-90 mark and has now retreated back to nothing. CD4 is closing on 300. I'm hoping in another 5 years I can make it to 500, FINGERS CROSSED!

CD4 is closing on 300. I'm hoping in another 5 years I can make it to 500, FINGERS CROSSED!

You'll get there. I never thought that I would get much above 300, but I did. And while I am still, out of range, of where my t cells should be, and where my percentage should be, I am doing a hell of a lot better than 10 years ago. One day at a time !

this past AUG 2013, I got all the way up to 647 T-cells and now 6 months later I'am all the way down to 240

hopefully I'll rebound w/ the new meds, as long as I don't keep getting all of these secondary infections, I just got over a horrible bout of oral thrush so I'm also keeping my fingers crossed for higher numbers

HUGS

DEN

Logged

"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

These are improvements in both. My Viral Load had a blip 2 tests in a row to around the 80-90 mark and has now retreated back to nothing. CD4 is closing on 300. I'm hoping in another 5 years I can make it to 500, FINGERS CROSSED!

All 4 off them Alec.

Logged

"If we can find the money to kill people, we can find the money to help people ." Tony Benn